Williams B, Luckas M, Ellingham J H, Dain A, Wicks A C
Leicester General Hospital.
Lancet. 1988 Dec 10;2(8624):1349-51. doi: 10.1016/s0140-6736(88)90879-3.
During 1986, 1386 patients with simple dyspepsia were referred by general practitioners for endoscopy (686) or double-contrast barium meal examination (700) at Leicester General Hospital. 618 (45%) were under the age of 45 years. Abnormal findings were more common in older than younger dyspeptic patients (58% vs 40% at endoscopy, 69% vs 25% by barium meal). Malignant disorders were diagnosed in 5% at endoscopy and 3% at barium meal, but in no patient under 45 years old. The incidence of malignant disorders at endoscopy was analysed for the 6 years 1980-86. Of 707 cases identified, only 13 (1.8%) occurred in patients under 45 years old; all 13 had symptoms suggesting pathology more serious than simple dyspepsia. It can be concluded that young patients with simple dyspepsia are overinvestigated. A majority can be treated safely with antacids and/or histamine receptor type 2 antagonists.
1986年期间，1386例单纯消化不良患者由全科医生转诊至莱斯特综合医院接受内镜检查（686例）或双重对比钡餐检查（700例）。其中618例（45%）年龄在45岁以下。内镜检查发现异常在年龄较大的消化不良患者中比年轻患者更常见（内镜检查分别为58%和40%，钡餐检查分别为69%和25%）。内镜检查诊断出5%的恶性疾病，钡餐检查诊断出3%的恶性疾病，但45岁以下患者中无一例诊断为恶性疾病。对1980 - 1986年这6年的内镜检查恶性疾病发病率进行了分析。在707例确诊病例中，只有13例（1.8%）发生在45岁以下患者中；所有13例患者的症状都提示病情比单纯消化不良更为严重。可以得出结论，对单纯消化不良的年轻患者检查过度。大多数患者可以安全地使用抗酸剂和/或2型组胺受体拮抗剂进行治疗。
